دورية أكاديمية
Real-world use of MRI for risk stratification prior to prostate biopsy.
| العنوان: | Real-world use of MRI for risk stratification prior to prostate biopsy. |
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| المؤلفون: | Siddiqui MR; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. mohammad.siddiqui2@northwester.edu., Ansbro B; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Shah PV; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Aguiar JA; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Li EV; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Rich JM; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Mahenthiran AK; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Moataz SAS; Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Keeter MK; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Mai Q; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Mi X; Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Schaeffer EM; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Ross AE; Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. |
| المصدر: | Prostate cancer and prostatic diseases [Prostate Cancer Prostatic Dis] 2023 Jun; Vol. 26 (2), pp. 353-359. Date of Electronic Publication: 2022 May 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Nature Publishing Group Country of Publication: England NLM ID: 9815755 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5608 (Electronic) Linking ISSN: 13657852 NLM ISO Abbreviation: Prostate Cancer Prostatic Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2002->: London : Nature Publishing Group Original Publication: Houndmills, Basingstoke, UK : Stockton Press, c1997- |
| مواضيع طبية MeSH: | Prostate*/diagnostic imaging , Prostate*/pathology , Prostatic Neoplasms*/diagnostic imaging , Prostatic Neoplasms*/epidemiology, Aged ; Male ; Humans ; United States ; Prostate-Specific Antigen ; Retrospective Studies ; Image-Guided Biopsy ; Medicare ; Biopsy ; Magnetic Resonance Imaging ; Risk Assessment |
| مستخلص: | Background: The utilization of MRI to risk stratify elevated PSA prior to prostate biopsy has been inconsistently adopted and varies considerably by practice setting. This study aims to evaluate the usage and performance of MRI as an advanced risk stratification tool of elevated PSA prior to biopsy and identify factors associated with differential utilization of MRI at a large academic setting with ready access to 3T multiparametric MRI of the prostate. Methods: A retrospective single-center study of 2900 men presenting with elevated PSA 2-20 ng/mL from 2018 through 2021 was conducted. We analyzed trends in MRI utilization and outcomes of prostate biopsy by MRI usage. Univariate and multivariate logistic regressions were performed to calculate odds ratios to identify patient- and provider-level predictors of MRI usage. Results: Rates of prebiopsy MRI utilization increased from 56% in 2018 to 89% in 2021 (p < 0.001). Prebiopsy MRI led to biopsy avoidance in 31% of men. MRI usage enhanced detection of clinically significant prostate cancer by 13% and reduced identification of Gleason Grade Group 1 disease by 3% and negative biopsies by 10% (p < 0.001). Men who received MRI were more likely to be younger than 75 years in age and have private or Medicare insurance, PSA >4 ng/mL, and PHI >27. In both univariate and multivariate analysis, black race and Medicaid insurance were associated with reduced MRI utilization (all p < 0.001). Urologic provider was an independent predictor of MRI usage (p < 0.001). Conclusions: Use of MRI as a risk stratification tool for elevated PSA rose during this 4-year study period. Men who self-identify as black or men with Medicaid coverage have diminished rates of MRI usage. Considerable provider-level variability in MRI use was observed. Future research aimed at identifying factors affecting implementation of MRI as a routine risk assessment tool is warranted. (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.) |
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| المشرفين على المادة: | EC 3.4.21.77 (Prostate-Specific Antigen) |
| تواريخ الأحداث: | Date Created: 20220513 Date Completed: 20230609 Latest Revision: 20230614 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1038/s41391-022-00543-4 |
| PMID: | 35551235 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1476-5608 |
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| DOI: | 10.1038/s41391-022-00543-4 |